摘要
目的 探讨血清胃泌素-17(G-17)、胃蛋白酶原(PG)及PG Ⅰ/PG Ⅱ(PGR)在慢性萎缩性胃炎(CAG)诊断中的应用价值.方法 回顾性选取2020年1月至2023年6月入芜湖市第一人民医院的80例CAG患者,将其设为观察组;同时,选取同一时期入院进行体检的80名健康者为对照组.采用荧光免疫双抗体夹心法定量测定两组研究对象的血清G-17、PG Ⅰ、PGⅡ及PGR水平,并进行两组对比;同时比较不同萎缩部位(胃体萎缩、全胃多灶萎缩、胃窦萎缩)的G-17、PG Ⅰ、PGⅡ及PGR水平.采用受试者操作特征(ROC)曲线分析G-17、PG Ⅰ、PGR单一与联合检测对CAG的诊断价值.结果 观察组患者的血清G-17、PG Ⅰ、PGR水平分别为(5.01±3.22)pmol/L、(53.28±18.24)μg/L、4.09±3.76,均明显低于对照组[(9.18±2.89)pmol/L、(88.47±20.72)μg/L、8.58±4.81],差异均有统计学意义(P＜0.05);两组患者的血清PGⅡ水平比较,差异无统计学意义(P＞0.05).胃体萎缩患者G-17水平为(17.46±2.46)pmol/L,高于全胃多灶萎缩患者[(15.44±2.48)pmol/L]、胃窦萎缩患者[(7.52±2.46)pmol/L],PG Ⅰ、PGⅡ 及PGR 水平分别为(34.28±3.49)μg/L、(4.16±1.14)μg/L、10.7±1.5,均低于全胃多灶萎缩患者[(44.12±4.91)μg/L、(8.47±1.55)μg/L、10.4±1.9]、胃窦萎缩患者[(89.58±14.23)μg/L、(7.45±1.56)μg/L、12.6±1.6],差异均有统计学意义(P＜0.05).ROC曲线分析结果显示,CAG诊断中G-17的临界值、ROC曲线下面积(AUC)、敏感度、特异度依次为 10.32 pmol/L、0.879、60.87％、70.09％,PG Ⅰ 依次为 106.09 μg/L、0.891、63.09％、75.57％,PGR 依次为 12.35、0.869、75.49％、75.18％,G-17、PG Ⅰ、PGR 联合诊断的 AUC、敏感度、特异度依次为 0.902、82.18％、68.09％.结论 CAG诊断中G-17与PG具有一定应用价值,G-17、PGⅠ水平过低提示CAG发生风险较高,且G-17、PG Ⅰ、PGR可用于辅助判断CAG患者的不同萎缩部位,G-17、PG Ⅰ、PGR联合检测不仅可进一步提升CAG诊断精准性,还可为CAG诊疗提供参考.
Abstract
Objective To explore the application value of serum gastrin-17(G-17),pepsinogen(PG)and PG Ⅰ/PG Ⅱ vatio(PGR)in the diagnosis of chronic atrophic gastritis(CAG).Methods Eighty patients with CAG admitted to The First People's Hospital of Wuhu from January 2020 to June 2023 were selected as the observation group;meanwhile,80 healthy patients admitted for physical examination during the same period were selected as the control group.The serum levels of G-17,PGⅠ,PG Ⅱ and PGR of both groups were measured and compared by sandwich method,and the levels of G-17,PG Ⅰ,PG Ⅱ and PGR in different atrophic sites(gastric body atrophy,whole gastric multifocal at-rophy and gastric antrum atrophy)were compared.The diagnostic values of G-17,the PGⅠ and PGR on CAG were analyzed using receiver operat-ing characteristic(ROC)curve.Results The serum levels of G-17,PG Ⅰ and PGR in the observation group were(5.01±3.22)pmol/L,(53.28±18.24)μg/L and 4.09±3.76,respectively,which were significantly lower than those in the control group[(9.18±2.89)pmol/L,(88.47±20.72)μg/L,8.58±4.81],the differences were statistically significant(P＜0.05);there was no statistically significant difference in serum PG Ⅱ level between the two groups(P＞0.05).The level of G-17 in patients with gastric body atrophy was(17.46±2.46)pmol/L,which was higher than that in patients with whole gastric multifocal atrophy[(15.44±2.48)pmol/L]and gastric antrum atrophy[(7.52±2.46)pmol/L],the levels of PG Ⅰ,PGⅡ and PGR were(34.28±3.49)μg/L,(4.16±1.14)μg/L and 10.7±1.5,respectively,which were lower than those in patients which whole gastric multifocal atrophy[(44.12±4.91)μg/L,(8.47±1.55)μg/L,10.4±1.9],patients with gastric antrum atrophy[(89.58±14.23)μg/L,(7.45±1.56)μg/L,12.6±1.6],the differences were statistically significant(P＜0.05).The ROC curve analysis results showed that,the cut-off value,G-17,area under the curve(AUC),sensitivity and specificity in CAG diagnosis were 10.32 pmol/L,0.879,60.87％,70.09％,PGⅠ of 106.09 μg/L,0.891,63.09％and 75.57％,PGR were 12.35,0.869,75.49％and 75.18％,The AUC,sensitivity,and specificity of the combined diagnosis of G-17,PGⅠ,and PGR were 0.902,82.18％,and 68.09％,respectively.Conclusion G-17 and PG have certain application value in CAG diagnosis.The low level of G-17 and PGⅠ indicates that the risk of CAG is high,and G-17,PGⅠ and PGR can be used to assist the judgment of different sites of atrophy in CAG patients.The com-bined detection of G-17,PGⅠ and PGR can not only further improve the accuracy of CAG diagnosis,but also provide reference for CAG diagnosis and treatment.
基金项目
2020年度安徽省自然科学基金项目(2008085MH213)
维普
万方数据